Cognition and epilepsy: Cognitive screening test

ABSTRACT. Cognitive deficits often occur in people with epilepsy (PWE). However, in Brazil, PWE might not undergo neurocognitive evaluation due to the low number of validated tests available and lack of multidisciplinary teams in general epilepsy outpatient clinics. Objective: To correlate Brief Cognitive Battery-Edu (BCB-Edu) scores with epilepsy characteristics of 371 PWE. Methods: Clinical and cognitive assessment (MMSE, BCB-Edu) of 371 PWE aged >18 years was performed. The clinical aspects of epilepsy were correlated with BCB-Edu data. Cognitive data of PWE were compared against those of 95 healthy individuals (NC), with p-<0.05. Results: People with epilepsy had lower cognitive performance than individuals in the NC group. Cognitive aspects also differed according to epilepsy characteristics. Predictive factors for impairment in multiple cognitive domains were age and use of more than one antiepileptic drug (logistic regression; R2 Nagelkerke=0.135). Conclusion: Worse cognitive performance was found in PWE on different domains. There was a relationship between cognitive impairment and the aspects of epilepsy. BCB-Edu proved to be effective as a cognitive assessment screening test for epilepsy in adults.

摘要：癫痫患者（people with epilepsy, PWE）常出现认知功能损害。然而在巴西，由于可供使用的经效度验证的认知评估测试数量有限，且普通癫痫门诊缺乏多学科团队，癫痫患者往往无法接受神经认知评估。
研究目的：探讨简短认知筛查量表-教育版（Brief Cognitive Battery-Edu, BCB-Edu）得分与371例癫痫患者的癫痫临床特征之间的关联。
研究方法：纳入371名年龄≥18岁的癫痫患者，对其进行临床评估与认知评估（采用简易精神状态检查表（Mini-Mental State Examination, MMSE）以及BCB-Edu），将癫痫临床特征与BCB-Edu评估数据进行关联分析；同时将癫痫患者的认知数据与95名健康对照（healthy individuals, NC）进行对比，检验水准设定为p<0.05。
研究结果：癫痫患者的认知表现显著低于健康对照组；认知表现亦随癫痫临床特征的不同而存在差异。Logistic回归分析显示，年龄以及联合使用多种抗癫痫药物是多个认知领域受损的预测因素（Nagelkerke R²=0.135）。
研究结论：癫痫患者在多个认知领域均存在较差的认知表现；认知损害与癫痫的临床特征密切相关；BCB-Edu可作为成人癫痫患者认知筛查的有效评估工具。